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RELEASE FORM

AGREEMENT FOR PURCHASE AND AQION RELEASE FROM LIABILITY
PROFESSIONAL/COMMERCIAL USERS

As a professional/commercial user “User”, I certify that the signed User below is not a retail consumer and has the knowledge and expertise to properly utilize these therapeutic products without input from Aqion, LLC and its dba Aquacura and any other related entities “Seller”. Given the User’s confirmed level of expertise, User releases Seller, employees and agents from any liability arising from the use or mis-use of purchased products.

User certifies that the therapeutic remedy or remedies “Products” that are under US government supervision/regulations and purchased now and in the future from Seller will be used only for non-food fish (or other non-food aquatic species) use. User may NOT resell these products without the express written consent of Seller (see separate resale agreement).  Note: “non-food” in this agreement refers to aquatic species not cultivated for human consumption or cultivated for consumption by aquatic species that will be in turn consumed by humans. 

Furthermore, User certifies Products purchased from Seller will be not used, provided for use, or resold for use in human medical situations or for veterinarian use with animals under US governmental regulation or for fish or other aquatic life (including their eggs and young) destined for human consumption or for use in a country or legal jurisdiction in which covered products are prohibited. 

Lastly, this is a legal document confirming that the below signed entity releases Seller from liability if User violates any of the agreed prohibitions in this document. Any User violation can result in the suspension of purchases and possible reporting to appropriate authorities, by the Seller. 

Forms that are incomplete will be rejected. Shipment of products will not commence until a fully executed form is confirmed on file.

Dated: April 2, 2025

User's Name

First Name*

Last Name*
User's Age Acknowledgment*
I certify that I am 18 years of age or older
User's Information

Company Name
User's Signature*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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